Youdas, James W.

The quality of healthcare delivery is dependent on collaboration between various professional disciplines. Integrating opportunities for interprofessional learning in medical education programs will prepare future clinicians to be effective members of a multi‐disciplinary care team. We incorporated an ultrasound demonstration of the upper limb into the gross anatomy courses for first year medical (n=53) and physical therapy (n=28) students. Prior to participating in the learning experience, all students took a short individual pre‐test based on clinical concepts regarding the assigned study material. A physical medicine and rehabilitation physician demonstrated the use of ultrasound as a diagnostic and procedural tool for the shoulder and elbow. Following the demonstration, students worked within interprofessional teams (n=14 teams) to review the related anatomy on dissected specimens. At the end of the session, students worked within interprofessional teams to complete a collaborative post‐test. Team scores were compared to the mean individual score within each team using a paired t‐test. Students scored higher on the collaborative post‐test (5.7/6) than on the individual pre‐test (4.2/6), p <0.0001. Results suggest that working in interprofessional teams may enhance understanding and clinical application of anatomy, thereby reinforcing the benefit of an interdisciplinary team approach to patient care.

Interprofessional collaboration in healthcare is crucial for quality patient care. While it continues to be an expected competency, most educational programs lack interprofessional learning (IPL) experiences. We administered the five‐point Likert Readiness of Interprofessional Learning Scale (RIPLS) to first year medical (MD) and physical therapy (PT) students to evaluate attitudes toward IPL. Students agreed that “For small group learning to work, students need to trust and respect each other” (average of 4.6 out of five points). They also disagreed that learning with other healthcare students is a waste of time or unnecessary (averages of 1.91 and 1.98 respectively). Clearly students desire IPL experiences, and with this in mind, we established an IPL curriculum for their gross anatomy courses. Students were first grouped into interprofessional teams at a social event. In dissection lab, PT students taught upper limb and MD students taught thorax anatomy. We also conducted IPL anatomy based problem solving sessions in a classroom setting. Anatomy courses provide an ideal platform for IPL opportunities. Lab and classroom activities enable students to work together through a shared experience of understanding anatomical concepts from different perspectives. By establishing an IPL curriculum, we hoped to increase interprofessional collaboration early in students’ medical education. Our results indicate positive student attitude toward the learning experience.

Background: Suspension training systems, which use body weight resistance under unstable conditions, may be effective for muscle strengthening in persons with scapular dyskinesis or subacromial impingement syndrome. Hypothesis: Greater arm, scapular, and trunk muscle recruitment will occur during horizontal abduction row exercises. Study Design: Descriptive laboratory study. Level of Evidence: Level 5. Methods: Surface electromyography data were collected from 28 participants (14 men, 14 women). A total of 13 right-sided muscles were studied at a sampling frequency of 1000 Hz. Maximal voluntary isometric contractions (MVICs) were established. Participants completed 3 repetitions per exercise in random order. We compared muscle recruitment during 3 rowing exercises: low row, high row, and horizontal abduction row. Data were compared with repeated-measures analyses of variance and post hoc Bonferroni corrections. Results: For high row and horizontal abduction row conditions, the upper, middle, and lower trapezius and posterior deltoid demonstrated >60% MVIC magnitudes of recruitment, and the upper erector spinae demonstrated 40% to 60% MVIC magnitudes of recruitment, respectively. In contrast, in the low row exercise, 40% to 60% MVIC magnitudes of recruitment were observed only in the middle trapezius, latissimus dorsi, and posterior deltoid. Conclusion: With the suspension system, high row and horizontal abduction row exercises promote muscle strengthening (>50% MVIC) in the upper, middle, and lower fibers of the trapezius, posterior deltoid, and upper erector spinae. Clinical Relevance: Rowing exercises performed with suspension straps may be recommended for muscle strengthening in patients with scapular dyskinesis and subacromial impingement syndrome as well as for healthy persons in need of enhanced scapular muscle performance.

Quality of healthcare delivery is dependent on collaboration between professional disciplines. Integrating opportunities for interprofessional learning in health science education programs prepares future clinicians to function as effective members of a multi‐disciplinary care team. This study aimed to create a modified team‐based learning (TBL) environment utilizing ultrasound technology during an interprofessional learning activity to enhance musculoskeletal anatomy knowledge of first year medical (MD) and physical therapy (PT) students. An ultrasound demonstration of structures of the upper limb was incorporated into the gross anatomy courses for first‐year MD (n = 53) and PT (n = 28) students. Immediately before the learning experience, all students took an individual readiness assurance test (iRAT) based on clinical concepts regarding the assigned study material. Students observed while a physical medicine and rehabilitation physician demonstrated the use of ultrasound as a diagnostic and procedural tool for the shoulder and elbow. Following the demonstration, students worked within interprofessional teams (n = 14 teams, 5–6 students per team) to review the related anatomy on dissected specimens. At the end of the session, students worked within interprofessional teams to complete a collaborative clinical case‐based multiple choice post‐test. Team scores were compared to the mean individual score within each team with the Wilcoxon signed‐rank test. Students scored higher on the collaborative post‐test (95.2 ±10.2%) than on the iRAT (66.1 ± 13.9% for MD students and 76.2 ±14.2% for PT students, P < 0.0001). Results suggest that this interprofessional team activity facilitated an improved understanding and clinical application of anatomy. Anat Sci Educ 11: 94–99. © 2017 American Association of Anatomists.

AbstractBackground and Purpose. The causes of lumbopelvic imbalances in standing have been widely accepted by physical therapists, but there is a lack of scientific evidence available to support them. We examined the association between 9 variables and pelvic inclination and lumbar lordosis during relaxed standing. Subjects. Thirty men and 30 women with chronic low back pain (CLBP) for at least 4 months were examined (mean age=54.9 years, SD=9, range=40.4–69.8). Methods. Multiple linear regression modeling was used to assess the association of pelvic inclination and the magnitude of lumbar lordosis in standing with age, sex, body mass index (BMI), Oswestry Back Pain Disability Questionnaire (ODQ) scores, physical activity level, hip flexor muscle length, abdominal muscle force, and range of motion (ROM) for lumbar flexion and extension. Results. In women, age, BMI, and ODQ scores were associated univariately and multivariately with pelvic inclination. In men, lumbar extension ROM was related univariately to pelvic inclination; age, lumbar extension ROM, and ODQ scores were associated multivariately. Lumbar lordosis was associated univariately with only lumbar extension ROM for women and men. A weak correlation was found between angle of pelvic inclination and magnitude of lumbar lordosis in standing (r=.31 for women, r=.37 for men). Conclusion and Discussion. The odds ratio of having CLBP is increased if the score on the double-leg lowering test for abdominal muscles exceeds 50 degrees for men and 60 degrees for women. In patients with CLBP, the magnitude of the lumbar lordosis and pelvic inclination in standing is not associated with the force production of the abdominal muscles.

Medicine is increasingly focused on team‐based practice as interprofessional cooperation leads to better patient care. Thus, it is necessary to teach teamwork and collaboration with other health care professionals in undergraduate medical education to ensure that trainees entering the workforce are prepared to work in teams. Gross anatomy provides an opportunity to expose students to interprofessional education (IPE) early in their training. The purpose of this study is to describe an IPE experience and report if the experience has lasting influence on the participating students. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was administered to first year medical (MD) and physical therapy (PT) students at Mayo Medical School and Mayo School of Health Sciences. Results demonstrated an openness on the part of the students to IPE. Interprofessional education experiences were incorporated into gross anatomy courses in both medical and PT curricula. The IPE experiences included a social event, peer‐teaching, and collaborative clinical problem‐solving sessions. These sessions enhanced gross anatomy education by reinforcing previous material and providing the opportunity to work on clinical cases from the perspective of two healthcare disciplines. After course completion, students again completed the RIPLS. Finally, one year after course completion, students were asked to provide feedback on their experience. The post‐curricular RIPLS, similar to the pre‐curricular RIPLS, illustrated openness to IPE from both MD and PT students. There were however, significant differences in MD and PT perceptions of roles and responsibilities. One‐year follow‐up indicated long‐term retention of lessons learned during IPE. Anat Sci Educ 8: 317–323. © 2015 American Association of Anatomists.